Ortopedia, traumatologia, rehabilitacja
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Ortop Traumatol Rehabil · Oct 2017
Comparative StudyIliac Fascia Compartment Block and Analgesic Consumption in Patients Operated on for Hip Fracture.
Fractures of the proximal femur in elderly patients are a challenge for orthopedics, anesthe-sio-logy and geriatrics. Early mobilization reduces postoperative mortality among these patients. Effective anal-gesia is necessary to achieve this goal. ⋯ The iliac fascia compartment block produces effective postoperative analgesia and reduces postoperative opioid consumption.
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Ortop Traumatol Rehabil · Oct 2017
ReviewThe Use of Neurodynamic Techniques in the Conservative Treatment of Carpal Tunnel Syndrome - a Critical Appraisal of the Literature.
Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy, characterized by the presence of many sensory and motor abnormalities. In the physiotherapy of patients with CTS, neurodynamic tech-niques are very common, while the scientific literature does not show clear evidence of beneficial effects obtained by using these techniques. Therefore, the aim of this work was to critically evaluate the use of neurodynamic techniques in the conservative treatment of CTS. ⋯ 1. A review of existing studies evaluating the effec-tiveness of neurodynamic techniques in the treat-ment of CTS shows that most of them produced beneficial therapeutic effects. 2. Due to a considerable heteroge-n-ei--ty of the parti-cipants, study design and metho-do-logy of thera-peutic interventions, it is difficult to for-mulate a general conclusion. 3. Hence the need arises for further research to assess the effectiveness of neu-ro-dynamic techniques in conservative therapy of CTS based on a similar therapeutic methodology.
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Ortop Traumatol Rehabil · Oct 2017
Comparative StudyRadial Extracorporeal Shockwave Therapy and Ultrasound Therapy in the Treatment of Tennis Elbow Syndrome.
Both ultrasound and radial shockwave therapies are used to treat tennis elbow syndrome. The aim of this study was to compare the therapeutic efficacy of both therapies by assessing the reduction in pain intensity and frequency, restoration of mobility, and reduction in the need for pain medication. ⋯ 1. Both radial shockwave and ultrasound therapies cause a reduction in the intensity and frequency of pain that persists for at least 8 weeks, reducing the need for pain medication and improving the function of the treated upper limb. 2. Ultrasound therapy is less effective than radial shockwave therapy.
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Ortop Traumatol Rehabil · Aug 2017
Posterior Branches of Lumbar Spinal Nerves - Part III: Spinal Dorsal Ramus Mediated Back Pain - Pathomechanism, Symptomatology and Diagnostic Work-up.
Spinal Dorsal Ramus Mediated Back Pain is the second most frequently described condition (the first one being Lumbar Facet Syndrome) originating from pathology involving posterior branches of lumbar spinal nerves. Spinal Dorsal Ramus Mediated Back Pain was described as "thoracolumbar junction syndrome" by Maigne in 1989. As a rule, Spinal Dorsal Ramus Mediated Back Pain presents unilaterally within posterior branches at the levels Th11-12 and L1-2. ⋯ Diagnostic work-up may benefit from performance of the Kibler Fold Test to determine sensitivity of the tissues surrounding the iliac crest. Patients with Spinal Dorsal Ramus Mediated Back Pain respond well to manual manipulative techniques if these are delivered in a technically correct manner and address the appropriate segment. A recommended approach for patients with absolute contraindications to manipulation, i.e. advanced osteoporosis or osteogenesis imperfecta, is a block of the po-sterior branch of the spinal nerve involved.
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Ortop Traumatol Rehabil · Aug 2017
Review Case ReportsThe Challenges of Monoaxial Bone Transport in Orthopedics and Traumatology.
Bone defects represent the main challenging problem for the orthopedic surgeon and, consequently, they increase the duration of hospitalization, risk of complications and health expenditures. The aim of our observational, descriptive and retrospective study is to evaluate the outcomes of patients treated with a mo-nolateral external fixator for bone defects greater than 3 cm. ⋯ 1. A review of the literature related to our experience shows that bone transport is an effective tech-nique to repair loss of bone in the lower limbs. The use of a system of external fixation enables corrective actions throughout the treatment that can be in-dividualized on a case-by-case basis. In our experience, the LRS fixator (Orthofix) is a sta-ble, easy-to-use and very handy device. 2. In situations where soft tissue reconstruction procedures are needed, the size and shape of the splint should be such as not to constitute an obstacle. Fur-thermore, the use of pins rather than transfixation wires eliminates the risk of neuro / vascu-lar injury such as may occur during the application of a circular fixator. 3. The analysis of the cases presented here indicates that where possible the technique of bone transport produces good results and can often salvage the limb. Amputation should be reserved only for cases where the general and / or local preoperative status indicate that the surgeon can expect a poor result or when the compliance of the patient is determined to be inadequate.